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The observation unit (OU) is an appropriate bed choice for the initiation of patient education and therapy in the treatment of uncomplicated deep vein thrombosis/pulmonary embolism. Compared to inpatient care OU, treatment of venous thromboembolism (VTE) achieves similar effectiveness, increased patient satisfaction, is cost-effective, and relieves hospital bed shortage issues. Educational interventions in the OU allows the patient to safely transition into outpatient VTE therapy with comfort and insight. The OU allows for faster, safer, and more cost-effective VTE therapy and begins home therapy much quicker when compared to inpatient admission.
The COVID-19 pandemic impacted individuals worldwide, regardless of their geographic location, religious or political beliefs, occupation, or social standing. People’s experiences were directly impacted by lockdown measures, physical distancing, masks, vaccine recommendations, or illness of self or friend or family member, as well as by how their local and national elected officials and public health leaders managed and communicated about the pandemic. As people went into lockdown, they went online and found a proliferation of information both true and false about the pandemic. The constant deluge of online information, the new and evolving outbreak, and the worldwide impact created a complex health emergency. The COVID-19 pandemic brought emergency risk communication to the forefront of every health agency in the United States, from city to county to state to federal levels of government. This chapter provides an overview of public health preparedness; explains how Crisis and Emergency Risk Communication (CERC) is different from day-to-day public health communication; summarizes the CERC framework and phase-based messaging; and outlines how risk perception impacts the way people process information about health threats. A student case study analyzes a Legionnaires’ disease outbreak using the CERC framework. Reflection questions are included at the end of the chapter.
Human-embodied relations are being fundamentally transformed by increasingly globalised abstracting processes. Developments including the planetary reach of technoscience, cybercapitalism, and communications technologies. They are increasingly framing how we live our bodies. They enable phenomena as diverse as the global trade in body parts and the distribution of pharmaceuticals. However, there is also a less obvious reframing of our bodies going on. Biotechnologies have been steadily remaking the foundations of human procreation, gestation, and identity formation, albeit unevenly in different parts of the world. This enquiry weaves together related themes: modifying genetic organisms, reproducing human life, gestating a fetus, presenting sexual identity, and being vaccinated. In the case of COVID, a technoscientific fix is presented as necessary to mitigate the effects of a world turned upside down by the technologisation and exploitation of planetary ecology. Technoscience is displacing modern science. The chapter seeks to show how technoscientific intervention associated with ideologies of overcoming bodily constraint is remaking what it means to be human.
There is a substantial difference between the housing that older Americans prefer and the housing that the market supplies. While market failures and seniors’ resource constraints explain part of this mismatch, zoning laws, Medicare and Medicaid reimbursement policies, and health law also loom large. Older Americans strongly prefer to age in place, in home-like environments. This chapter focuses on two types of housing that facilitate that manner of aging: Green House nursing homes and accessory dwelling units. The chapter discusses the substantial benefits for seniors who rely on others for care, and those who can live independently, in these respective kinds of housing. These benefits include substantial health and quality-of-life advantages as well as the ability to maintain connectedness within existing social networks. The chapter further examines the legal impediments to the proliferation of these housing types and the measures that some forward-looking jurisdictions are taking to facilitate their growth.
Within a week, a no-name Republican state representative from a town of 384 people in Illinois catapulted from obscurity to a prime-time appearance on Fox News' Ingraham Angle. This newly empowered politician, Darren Bailey, would go on to steer the pro-business Republican party in Illinois toward extremism. Democratic backsliding emerges across all levels of politics, but the threats posed by small-town politicians have been overshadowed by national-level politicians. This microstudy of a single politician's debut in the public eye showcases a novel approach to media corpus construction that combines proprietary and open databases, aggregated search tools, and targeted searching, and includes local, regional, and national news across digital-first, radio, news publishers, broadcast and cable television, and social media. The Element provides unique insights into how American journalism creates space for small-town extremists to gain power, especially given declines in local news.
Youth depression is a critical target for early intervention due to its strong links with adult depression and long-term functional impairment. In low- and middle-income countries (LMICs) like the Philippines, limited epidemiological data hampers mental health service planning for youth. This study analyzed nationally representative survey data from 2013 (n = 19,178) and 2021 (n = 10,949) to estimate the prevalence of moderate to severe depressive symptoms (MSDS) among Filipinos aged 15–24 years, using the 11-item version of the Center for Epidemiologic Studies Depression Scale. Survey-weighted analyses revealed that MSDS prevalence more than doubled from 9.6% in 2013 to 20.9% in 2021. The rise was most pronounced among females (10.8% to 24.3%), non-cisgender or homonormative individuals (9.7% to 32.3%), youth with primary education or less (10.8% to 26.5%), youth from economically disadvantaged households (10.6% to 25.1%) and youth who were separated, widowed or divorced (18.3% to 41.3%). Disparities in MSDS also widened over time, with some groups bearing a disproportionate burden. These findings underscore the need to expand accessible, high-quality mental health services for youth in LMICs, such as the Philippines. Continued monitoring and targeted interventions are essential to address the rising burden of depression, particularly among underserved and disproportionately affected groups.
How corrupt is the United States of America? While the US presents itself as an exemplar of democratic government and politics, many citizens see it as highly corrupt. In this book, Oguzhan Dincer and Michael Johnston explore corruption across a range of policy areas in all fifty states using two major forms of corruption – legal and illegal – via three proxy measures of corruption. They not only estimate the pervasiveness of such corruption in each state, but also compare and contrast their causes, consequences, and implications for contemporary issues including racial inequities, public health policy, and the environment, while also highlighting issues of citizen participation and trust in political processes. The book presents no reform toolkits or quick fixes for American corruption problems, but frames key challenges of institutional change and democratic political revival that can be used in the struggle to build a more just, and better-governed, society.
Scientific advances to fight infectious diseases have been remarkable. International law and global governance have sought, and often failed, to keep pace, secure equity, and stop outbreaks. We trace the law and governance model emerging from early failure in the AIDS response and identify four elements: use of law by national governments to compel sharing; decentralized generic manufacturing; mechanisms for voluntary sharing of patents and technology transfer; international funding. In combination, these created a remarkable new ecosystem. We find that when COVID-19 hit and mRNA vaccines were rapidly developed, global North governments opposed mobilizing this synergistic model. Instead, equity efforts focused on financing purchase of vaccines from originator companies with little use of law. Amidst monopolies and scarcity of doses, vaccine nationalism fatally undermined this effort. Whether more synergistic law and governance emerges from rapidly changing global health law will likely dictate the efficacy of future global infectious disease response.
I have always been interested in research that was relevant to real life and the real world. I was never interested in phenomena that were confined to behavior in a laboratory. My research ended up connecting not just with other people’s lives, but with my own life. That is, my research influenced my life; and my life influenced my research. The latter was evident in my research on the development of language and communication in children, chimpanzees, and bonobos. The former was evident in my COVID research where I drew upon my longitudinal study of a Maya community to realize during the pandemic – and empirically demonstrate – that parenting, child behavior, adult activities, and values in a rural subsistence ecology are quickly revived in modern human beings when such responses are needed to adapt to survival threat and a contraction of the social world. Those findings, in turn, have reinforced my focus on the dynamic interaction of social change, cultural evolution, and human development.
We live at a time when experts are increasingly viewed with distrust. Conservative Member of Parliament Michael Gove famously said that ‘The people of this country have had enough of experts.’ In this interview, philosopher Linda Zagzebski explores some key questions concerning experts, including: What is an expert? How does an expert differ from an authority? And: What can we do to foster a healthier relationship between experts and non-experts?
Departing from the conventional narrative that views borders exclusively as a source of hostility in inter-Asian relations, this book tells a story of how two revolutionary states launched movements and pursued policies that echoed each other as well as collaborated in extending their authority to the border to temper the transnational tendencies there – a process that the author characterizes as “joint state invasion,” which challenges both the Scottian narrative of state evasion and the Tillyan model of state formation. The Guangxi-northeastern Vietnam border is geographically, economically, and ethnically diverse and includes highlands, lowlands, and access to the Gulf of Tonkin. State activities at the border in the second half of the twentieth century were initiated in the context of historical precedents of successful, and equally importantly, unsuccessful state intrusions into the borderlands. There was a qualitative difference between state activities on the Sino-Vietnamese border that began during the Cold War and those that came before, where “distracted states” facing continuous wars were often unable to devote adequate resources to the task of border making. More importantly, limited coordination between the successive Chinese governments and the French colonial state left the border people significant “wiggle room” to circumvent the political authority.
Any fair evaluation of the Conservative effect (2010–14) must be cognisant of the context. Tom Egerton’s chapter will place the Conservative premierships in the six external shocks Britain faced, beginning with the Great Financial Crash and the Eurozone Crisis, before the impact of Brexit (and a debate over its external and structural causes), Covid, the Russo-Ukrainian War and the inflation crisis. How did each government succeed or fail in the face of compounding shocks? What opportunities and constraints emerged as a result? Only through an analysis of a decade of poly-crisis, and in the perspective of wider political change, can we make a conclusion on the question of ‘fourteen wasted years’.
In Chapter 13, we provide a preliminary analysis of the policy orientation of the EU’s post-Covid-19 new economic governance (NEG) regime to give policymakers, unionists, and social-movement activists an idea about possible future trajectories of EU governance of employment relations and public services. We do that on the basis of not only the recently adopted EU laws in these two policy areas, such as the decommodifying Minimum Wage Directive, but also EU executives’ post-Covid-19 NEG prescriptions in two areas (employment relations, public services), three public sectors (transport services, water services, healthcare services), and four countries (Germany, Italy, Ireland, Romania). Vertical NEG interventions in national wage policies paradoxically cleared the way for the decommodifying EU Minimum Wage Directive by effectively making wage policy an EU policymaking issue, but, in the area of public services, we see an accentuation of the trend of NEG prescriptions in recent years: more public investments but also much more private sector involvement in the delivery of public services.
Chapter 14 concludes the book, highlighting its major theoretical and practical insights for the study of EU integration and for the prospects of democracy in Europe. The technocratic design of the EU’s new economic governance (NEG) regime eschewed citizens’ and workers’ political rights to have a say in policymaking; and the commodifying bent of its prescriptions eroded their social rights to be protected from the vagaries of the market. After the pandemic, the technocratic bent in EU economic governance endured, as the National Recovery and Resilience Plans were co-designed by national and EU executives without any meaningful input from unions and social movements, and without national parliaments and the European Parliament making any amendments. The commodifying direction of the NEG regime also endured post-Covid, albeit with some concessions, notably in employment relations. EU executives have had to face the prospect that the hollowing out of social rights that resulted from commodification is pushing electorates towards Eurosceptic parties. In the current unstable context, labour politics matters a lot. Unions and social movements are essential in framing the social and political struggles about the policy direction of EU economic governance along a commodification–decommodification axis rather than a national–EU politics axis.
Joe Biden’s first two years became a turning point. The country had reached a point where it was obvious that the mix of government and markets had titled too much in the direction of markets. Besides the COVID pandemic, Biden confronted growing inflation, an economic recession, and Trump’s refusal to do anything to address climate change, together with a deeply divided partisan Congress. Biden galvanized the Democrats to unite around significant and bold responses and even obtained bipartisan support for some of his legislative agenda. He passed legislation to address COVID and increase government investment in infrastructure and technological developments. Regarding these successes and the inability to do more, Biden focused on how the balance between government and markets depends on the role of government right-sizing that balance by trying to restore confidence in American government and American democracy.
Bashing bureaucrats is an old American political tradition, and no one took this further than Donald Trump, who actively sought to fire civil servants and find other ways to subvert the bureaucracy. Over the nation’s history, the government has taken on an increasing and successful role in ensuring prosperity, protecting people, and promoting equality, and this success is due in no small part to the contribution of civil servants. Like all institutions, the government fails because its employees let it down, but it also fails because of incompetent political leaders who ignore the advice of knowledgeable and experienced civil servants or reject their advice because it conflicts with an ideological agenda. Andrew Jackson famously thought running the government did not require any special skills, and Donald Trump went even further in thinking that he did not need to know anything about how the government ran or what the civil service advised. The results were disastrous for both presidents and the country. Government needs administration, especially in times of emergency, and government needs public servants like Anthony Fauci to carry out its programs.
Community-based psychosocial support (CB-PSS) interventions utilizing task sharing and varied (in-person, remote) modalities are essential strategies to meet mental health needs, including during the COVID-19 pandemic. However, knowledge gaps remain regarding feasibility and effectiveness.
Methods
This study assesses feasibility, acceptability and preliminary effectiveness of a CB-PSS intervention for conflict-affected adults in Colombia through parallel randomized controlled trials, one delivered in-person (n = 165) and the other remotely (n = 103), implemented during the COVID-19 pandemic and national protests. Interventions were facilitated by nonspecialist community members and consisted of eight problem-solving and expressive group sessions.
Findings
Attendance was moderate and fidelity was high in both modalities. Participants in both modalities reported high levels of satisfaction, with in-person participants reporting increased comfort expressing emotions and more positive experiences with research protocols. Symptoms of depression, anxiety and posttraumatic stress disorder improved among in-person participants, but there were no significant changes for remote participants in comparison to waitlist controls.
Implications
This CB-PSS intervention appears feasible and acceptable in both in-person and remote modalities and associated with reduction in some forms of distress when conducted in-person but not when conducted remotely. Methodological limitations and potential explanations and areas for future research are discussed, drawing from related studies.
Nonresponse is a challenge in many fields, including demography, economics, public health, sociology, and business. This chapter explores nonpolitical manifestations of nonignorable nonresponse by focusing on population health. For many conditions, the decision to get tested or the willingness to allow a test is deeply wrapped up in the likelihood of having the condition. During Covid, for example, people who thought they might have been exposed to the virus were almost certainly more likely to get tested meaning that nonignorable nonresponse complicated our ability to understand the Covid outbreak. Section 13.1 discusses the challenge of estimating public health variables in terms of a nonignorable missing data problem. Section 13.2 explores how first-stage instruments can improve the efficiency and accuracy of efforts to assess prevalence. Section 13.3 presents a framework for comparing Covid positivity rates across regions even when testing rates differ.
Pre-pandemic, employer-sponsored health insurance (ESI) covered 175 million workers and their dependents, the equivalent of 49% of the country’s total population. ESI, a valuable tax preference to employer and employee alike, spurred worker job dependence on employers resulting in access to healthcare dependent upon continued employment. With the advent of the pandemic and the dramatic increase in unemployment, the number of uninsured increased by more than 2.7 million people. Then, unemployment proliferated further by an unprecedented exit from the workforce dubbed the “Great Resignation.” Over 47 million Americans voluntarily quit their jobs in a movement characterized as a general labor strike. The pandemic opened the floodgates to workers’ concerns about COVID safety in the workplace, wage stagnation despite increases in the cost of living, enduring job dissatisfaction, and increased demand for a remote-working environment. Data shows that the unemployed shifted to the Affordable Care Act marketplace or to the public payer option, Medicaid, for coverage. This shift signals a change, post-pandemic, away from the destabilizing system of access to care based on employment and unwanted job dependence and provides a policy argument favoring the more stabilizing influence of public insurance options in the health insurance market.